Gallbladder Surgery: What You Should Know

Gallstones are the most common reason for gallbladder surgery. However, there may be other reasons like inflammation of the gallbladder (cholecystitis) or even large polyps, which may necessitate gallbladder surgery.

Here is what you should know about gallbladder surgery:

Before the Surgery

Following are a few pre-operative measures that you will have to follow before cholecystectomy:

• Avoid eating or drinking before the surgery.
• Take only approved medications (with a small sip of water).
• Take a bath before going to the hospital.
• Do not apply any cosmetics or makeup, for they may be inflammable. Also, remove jewelry and contact lens, if any.
• Do not shave the surgical area.
• Carry a photo ID and be prepared to answer important case-related questions.

During the Surgery

Depending on the methods and instruments of operation, gallbladder surgery can be:

• Minimally Invasive Surgery: The laparoscopic procedure involves using a thin, tube-like instrument with a light and lens for viewing, which is inserted into the abdomen via incisions.
• Robotic Surgery: The surgeon operates using a robot that they control via a computer console. Greater precision and a 3D view of the target site are available in this form of surgery.

Open Surgery

It is the traditional method of making a large incision to get a full view of the gallbladder.

Tests

Though most preliminary tests are performed before the surgery, a few tests will have to be performed either immediately before or during the gallbladder surgery. These are:

• Intraoperative Cholangiogram

  Here a dye is injected into the bile duct, and an X-ray (cholangiogram) is taken to determine the presence of stones.

• Laparoscopic Ultrasound (LUS)

  Performed as an alternative to cholangiogram, the purpose of this test is to locate the common bile duct and common hepatic duct to prevent any accidental surgical damage.

Steps Involved in Gallbladder Removal

Laparoscopic or Robotic Surgery

The following steps performed are common to both laparoscopic and robotic surgeries. The only difference is that the latter makes use of a computer-operated robot while in the former the surgeon makes use of his hands:

• Induced Sleep: The patient will be put to sleep using general anesthesia.
• Creation of incision and insertion of port: A small incision is made close to the belly button, with a port inserted via the incision. (The port is a small device that creates an opening to fill the abdomen with carbon dioxide gas, which expands the injected area for optimal viewing of the gallbladder, bile ducts, and adjacent organs).
• Insertion of a camera through the port: this inserted camera is connected to a TV screen in the operating room.
• Addition of ports for placing small instruments.
• Removal of the gallbladder and its retrieval through one of three to four small incisions.
• Closure of the incision with tiny stitches, staples, or surgical glue. These will automatically disappear as the wounds heal.

Open Surgery

It involves a much larger incision (6-inch) made in the abdomen. When pulled back, the muscle tissue reveals the gallbladder, which is removed using comparatively larger surgical instruments. After the removal, the incision is dressed and the patient is transferred to the recovery room.

After the Surgery

• The patient is taken to the recovery room and is carefully monitored for any post-op complications.
• The vital signs (pulse, blood pressure, breathing, and temperature) are checked frequently.
• In uncomplicated cholecystectomy, patients are expected to stay in the recovery room for at least an hour.

Resuming Normal Activities

In the case of laparoscopic or robotic surgery, normal non-strenuous activities may be resumed within 1 to 2 weeks, whereas a gap of at least a month is advised before indulging in heavy, physically demanding jobs.

In the case of open surgery, a rest of 4 to 6 weeks must be taken before resuming normal activities. In either case, it is always advisable to consult your healthcare provider before resuming normal activities.

To learn more about gallbladder surgery, contact us.